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Presentation comparison
EmergencyCovers delirium, acute confusion, toxic-metabolic encephalopathy, and post-ictal confusion.
2 of 7 diagnoses compared
| CriteriaComparison detail | DeliriumEmergency |
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Inattention plus altered awareness/arousal are the key separators. Usually precipitated by acute illness, surgery, injury, retention, constipation, pain, or medicines.
Clinical reference — not validated decision support. Review before use.
| Substance intoxicationEmergencyNot selected |
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| Post-ictal stateEmergencyNot selected |
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| Dementia with superimposed deliriumEmergencyNot selected |
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| Wernicke encephalopathyEmergencyNot selected |
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| Hepatic encephalopathyEmergencyNot selected |
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| Why it fits | Acute change, fluctuating course, inattention | Time course, tremor, sweats, tachycardia, hypertension, anxiety, seizures | Time-link to use, toxidrome clues (pupils, RR, nystagmus, tremor) | Witnessed or suspected seizure, stereotyped event, post-event confusion | Known cognitive disorder with sudden worsening | Heavy alcohol use, malnutrition, triad of confusion/ataxia/eye signs may be incomplete | Liver disease, asterixis, GI bleed, constipation, infection |
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| What argues against | Applies to the whole presentationPrimary psychosis, dementia | ||||||
| Must-not-miss | Sepsis, hypoxia, hypoglycaemia, stroke, intracranial bleed, alcohol/benzo withdrawal, urinary retention, faecal impaction | Alcohol/benzo withdrawal seizures, delirium tremens, severe GHB withdrawal | Opioid respiratory depression, head injury | ||||
| Bedside question | Applies to the whole presentationInattention plus altered awareness/arousal are the key separators. Usually precipitated by acute illness, surgery, injury, retention, constipation, pain, or medicines. | ||||||
| Immediate action | Applies to the whole presentationDo vitals, BGL, sats, attention testing, collateral, and medication/substance review early Use 4AT in most adult settings, and ICU tools where appropriate | ||||||
| Investigations | Applies to the whole presentationBlood glucose, Vitals and oxygen saturation | ||||||
| Mimics / overlap | Applies to the whole presentationPrimary psychosis, dementia, severe depression, catatonia | ||||||
Scroll horizontally to review more candidate differentials. Clinical reference — not validated decision support. Review before use.
Primary psychosis, dementia
Inattention plus altered awareness/arousal are the key separators. Usually precipitated by acute illness, surgery, injury, retention, constipation, pain, or medicines.
Do vitals, BGL, sats, attention testing, collateral, and medication/substance review early Use 4AT in most adult settings, and ICU tools where appropriate
Blood glucose, Vitals and oxygen saturation
Primary psychosis, dementia, severe depression, catatonia
Acute change, fluctuating course, inattention
Sepsis, hypoxia, hypoglycaemia, stroke, intracranial bleed, alcohol/benzo withdrawal, urinary retention, faecal impaction
Time course, tremor, sweats, tachycardia, hypertension, anxiety, seizures
Alcohol/benzo withdrawal seizures, delirium tremens
Safety first. Act early.
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Last updated: Pending review
| Non-convulsive status epilepticus, head injury |
| Infection, retention, constipation, dehydration, medication toxicity, pain |
| Permanent cognitive injury, Korsakoff syndrome |
| GI bleed, sepsis, over-sedation, impending coma |